Establishing the foundation for a multicancer early detection consortium

Precision medicine and diagnostics, Health system readiness
/ Healthcare

Multicancer Early Detection Consortium, September 2021

Multicancer early detection (MCED) is an emerging set of technologies that—with a blood, breath, urine, saliva, or stool sample—can enable clinicians to rapidly screen for multiple cancer types at once. These technologies could potentially be used in clinical care to screen asymptomatic individuals for signals of cancer, detect cancer earlier in symptomatic patients, and monitor cancer patients or survivors for residual or new signals of cancer.

Conversations around MCED technologies tend to center on their perceived ability to be used as a screen for early signals of cancer, when treatments are more likely to lead to better outcomes.[i] However, the introduction of MCED technologies will require careful risk-benefit analyses. While there are likely benefits to screening and diagnostic programs, these can also introduce patient harms (e.g., in leading to potential false-positive results). Additionally, many stakeholders in the healthcare community recall past medical innovations with troubled introductions into clinical care that led to public confusion.[ii] Stakeholders fear that if the technologies are not properly evaluated for their clinical applicability—and clinicians and health systems do not proactively prepare for their implementation—the public will lose confidence in the technologies before they are optimized.   

With the above challenges in mind, a group of leading public and private healthcare stakeholders recommended forming a consortium to evaluate the clinical and public health value of MCED.[iii] Subsequently, during the first half of 2021, a voluntary group of steering committee members and advisers representing a range of perspectives across the healthcare sector—including primary-care, population-health, and oncology clinicians and academics; payers; not-for-profit/patient-advocacy organizations; and industry representatives—initiated work to design this consortium. The MCED Consortium would help establish standards and implementation guidance for using MCED technologies in clinical care and seek to understand and address the impact of these technologies, especially on health equity.

This Summary of Themes synthesizes the MCED Consortium design effort, which built upon work in 2020, ran for the first half of 2021, and concluded with the creation of the MCED Consortium Blueprint, a consensus document that lays out the mission, scope, objectives, governance, work plans, and operating model for the group. The blueprint lays the foundation for a public-private collaborative that will be formalized as a not-for-profit organization.  

[i] Cancer,” World Health Organization, March 3, 2020.  
[ii] Stakeholders typically referred to lessons from prostate-specific antigen screening, 23andMe’s direct-to-consumer genetic-risk screening, and Theranos’s fraud case and ultimate closing. For more information on these topics see “Confronting A Controversy—The PSA Question,” Premier Medical Group, May 14, 2020; Megan A. Allyse et al., “Direct-to-Consumer Testing 2.0: Emerging Models of Direct-to-Consumer Genetic Testing,” Mayo Clinic Proceedings 93, no. 1 (January 2018), 113–120; and Lydia Ramsey Pflanzer, “The Rise and Fall of Theranos, the Blood-Testing Startup That Went from Silicon Valley Darling to Facing Fraud Charges,” Business Insider, April 11, 2019.
[iii] Multicancer Early Detection Forum, Designing a Public-Private Consortium to Address the Challenges of Multicancer Early Detection, ViewPoints (Waltham, MA: Tapestry Networks, 2021), 5–7.